British Journal of Sports Medicine最新文献

{"title":"Enhancing access to prostheses in sports: a call to action for the future of Paralympic athletes","authors":"Ashley Iain Simpson","doi":"10.1136/bjsports-2024-109113","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109113","url":null,"abstract":"The recent call by Paralympic champion Richard Whitehead for improved access to advanced prosthetics within the National Health Service (NHS) underscores a critical issue in sports and rehabilitation: the need for prostheses that not only restore basic function but also empower individuals to excel in athletic pursuits1. This editorial explores the importance of prostheses in sport, the current challenges faced by aspiring athletes and the imperative to enhance access to cutting-edge prosthetic technology to foster the next generation of Paralympic champions. Advances in limb prostheses have revolutionised the possibilities for athletes with limb loss or limb deficiency. These devices, now often equipped with microprocessors, advanced materials and biomechanical features, enable athletes to perform complex movements, maintain balance and optimise their performance in ways that traditional prosthetics cannot.2 In sports, where precision, speed and agility are critical, the functionality of prostheses can be the determining factor between participation and elite performance. Biomechatronic prostheses incorporate active elements like sensors, actuators and microprocessors that support adaptive movement and user-specific responses, mainly intended for everyday life rather than sporting competition.3 In contrast, passive sports prostheses rely on advanced but non-powered materials - such as carbon fibre - to optimise performance by maximising energy storage and return.3 In Paralympic athletics, prostheses are tightly regulated to maintain fair competition. Only passive prosthetic systems are permitted, as powered prostheses could create an unfair advantage and lead to a technological arms race.4 Athletes with lower-limb impairments competing with prosthetics fall into classifications T61–T64 (for track) and F61–F64 (for field events), depending on the type and level of impairment.4 These classifications ensure that athletes compete with others who have similar functional abilities. Early access to biomechatronic devices, alongside passive sports-specific prosthetics, could significantly benefit young athletes. Biomechatronic prostheses provide adaptive functionality that …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"91 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142841620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of postpartum exercise on pelvic floor disorders and diastasis recti abdominis: a systematic review and meta-analysis","authors":"Nicole F Beamish, Margie H Davenport, Muhammad Usman Ali, Matthew J Gervais, Talia Noel Sjwed, Gyanjot Bains, Allison Sivak, Rita E Deering, Stephanie-May Ruchat","doi":"10.1136/bjsports-2024-108619","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108619","url":null,"abstract":"Objective To examine the effect of exercise during the first year postpartum on pelvic floor disorders and diastasis recti abdominis. Design Systematic review with random effects meta-analysis. Data sources: MEDLINE, EMBASE, CINAHL, SPORTDiscuss, Evidence-Based Medicine Reviews (Ovid), Scopus, Web of Science and ClinicalTrials.gov were searched until 12 January 2024. Eligibility criteria for selecting studies Studies of all designs (except case studies) and languages were included if they contained information on the Population (individuals in the first year postpartum), Intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise alone (‘exercise-only’) or in combination with other intervention (eg, biofeedback; ‘exercise+co-intervention’)), Comparator (no exercise or different exercise measures) and Outcome (symptom severity and risk of urinary incontinence, anal incontinence, pelvic organ prolapse, diastasis recti abdominis and sexual function). Results 65 studies (n=21 334 participants) from 24 countries were included. ‘Moderate’ certainty of evidence revealed that pelvic floor muscle training reduced the odds of urinary incontinence by 37% (seven randomised controlled trials (RCTs), n=1930; OR 0.63, 95% CI 0.41 to 0.97, I2 72%) and pelvic organ prolapse by 56% (one RCT, n=123; OR 0.44, 95% CI 0.21 to 0.91) compared with control groups. ‘Low’ certainty of evidence showed a greater reduction in inter-rectus distance measured at rest and during a head lift following abdominal muscle training compared with no exercise. Evidence on the effect of exercise on the risk of anal incontinence and diastasis recti abdominis, as well as the severity of anal incontinence, urinary incontinence, pelvic organ prolapse and sexual function, is limited. Conclusion Evidence supports the effectiveness of postpartum pelvic floor muscle training in reducing the odds of urinary incontinence and pelvic organ prolapse and postpartum abdominal exercise training in reducing inter-rectus distance. PROSPERO registration number CRD42022359282. Data are available on reasonable request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"119 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142841553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Dawn of Health Home' team: promoting health and empowering underdeveloped rural areas in China through exercise.","authors":"Lin Yang, Chunfang Zhang, Bofan Chen, Haimin Zeng, Xinxing Zeng, Jie Peng, Liang Hao","doi":"10.1136/bjsports-2024-108349","DOIUrl":"10.1136/bjsports-2024-108349","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"1554-1556"},"PeriodicalIF":11.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The digital mirror: how generative artificial intelligence reflects and amplifies gender bias","authors":"James P MacDonald, Madeleine Pape, Kathryn E Ackerman, Eva Carneiro, Yungui Huang, Katherine H Rizzone, Phathokuhle Cele Zondi, Margo Mountjoy","doi":"10.1136/bjsports-2024-108998","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108998","url":null,"abstract":"We live in unprecedented times for women in sport. In the USA, the 2024 collegiate basketball finals marked the first time in broadcast history that viewership of the women’s championship game was higher than the men’s.1 Internationally, the 2024 Paris Games were the most gender equal in Olympic history in terms of numerical parity on the playing field.2 Despite such progress, gender inequities in sport persist, which social scientists partially attribute to the harmful effects of stereotypical and often sexualised representations of women in sports media.3 As generative artificial intelligence (GAI) is increasingly leveraged for visual communication of sport, the risk of amplifying gender stereotypes is profound.4 Recently, authors of this editorial (J.M. and M.M.) created an image for social media use to promote findings from a study on inequities in training environments of elite women golfers.5 A GAI tool was prompted to ‘provide an image of women golfers.’ Dissatisfied with the initial stereotypical result, a second prompt was given: ‘show a more diverse representation of body types and ethnicity.’ There is much to deconstruct in the output (figure 1); at …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"9 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging passive exercise to support brain health","authors":"Benjamin Tari, Matthew Heath, Fabian Herold, Boris Cheval, Flaminia Ronca, Jennifer L Etnier, Joseph T Costello, Nicole E Logan, Megan Cully, Liye Zou","doi":"10.1136/bjsports-2024-109129","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109129","url":null,"abstract":"Clinicians and practitioners have used passive exercise to improve mobility; however, research designed to systematically explore its effects is not well developed. This editorial will highlight evidence from studies of acute bouts of passive exercise that could be leveraged to understand whether regular passive exercise could maintain and improve brain health. Regular active exercise (ie, volitional aerobic/resistance exercise) has numerous health benefits, including, but not limited to, improved functional abilities (eg, mobility), reduced risk of developing diseases, improved brain health and cognition, and facilitated recovery following a medical event (eg, acute injury).1 For example, active exercise can improve clinical recovery in individuals with a recent traumatic brain injury and reduce the risk of persistent post-concussive symptoms.2 For individuals who are unable to actively exercise (eg, unconscious, paralysed or sedated patients, stroke or spinal cord injury, Parkinson’s disease), passive exercise is usually prescribed in settings such as in hospitals, rehabilitation clinics or care homes.3 Passive exercise is completed independently of an individual’s volitional effort and relies entirely on an external force to move an individual’s limbs. In this framework, passive exercise involves movement through a specified range of motion, often via therapist-assisted movement and/or via a mechanically driven flywheel or stationary tandem bicycle. In this context, the overarching goal of passive exercise is to maintain or improve mobility and prevent further musculoskeletal complications. However, the specific promotion of brain health via passive exercise prescription is often overlooked. Promising early research from Ridgel …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"28 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New framework for the continuum of concussion and functional neurological disorder","authors":"Matthew J Burke, Noah D Silverberg","doi":"10.1136/bjsports-2024-108154","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108154","url":null,"abstract":"Over the past 20 years, scientific investigation and public awareness of concussion has expanded exponentially. This has represented a critical swing of the pendulum for a field that previously had been somewhat ignored by the medical establishment, research funders and health policy-makers. Although substantial progress has been made in better identification and management of acute concussion, many knowledge gaps remain.1 One of the largest ongoing conundrums surrounds the 15%–30% of patients who experience persistent postconcussion symptoms (PPCS) that can last months to years.2 3 This editorial explores how better understanding the continuum between concussion/PPCS and functional neurological disorder (FND) could advance concussion care and research. Running parallel over this time has been an evolving understanding of FND (previously termed conversion disorder). FND can be defined as the presence of involuntary neurological symptoms that are incompatible with conventional neurological diseases.4 This can be likened to a ‘software’ (functional) problem of brain circuits rather than a ‘hardware’ (structural) disease of the nervous system. FND is involuntary and should not be conflated with malingering (deliberate production or exaggeration of symptoms for external gain, eg, financial compensation). FND symptom subtypes include functional movement disorders, functional paralysis, functional seizures, functional sensory disorders, functional cognitive disorder and functional dizziness (also known as persistent postural perceptual dizziness (PPPD)). The latter two phenotypes have particular relevance to considerations surrounding PPCS. Recent efforts in the study of FND have focused on transitioning away from a diagnosis of exclusion towards incorporating validated ‘rule-in’ signs based on characteristics of internal inconsistency, distractibility and variability of symptoms (ie, fluctuations with shifts in attention).5 FND is commonly seen across medical practice and is among the most frequent clinical presentations in outpatient general neurology clinics.6 There is a female preponderance (60%–80%) with the mean age of onset being between …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"22 4 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary reporting in sports injury epidemiology: choosing words carefully and considering a Holistic Injury Impact Framework","authors":"Avinash Chandran, Travis Anderson, Eric G Post, Zachary Y Kerr, William M Adams","doi":"10.1136/bjsports-2024-108564","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108564","url":null,"abstract":"In recent years, there has been a noticeable amount of discussion surrounding reporting methods in sports injury epidemiology.1–3 Particular emphasis has been placed on characterising the scope of impact that an injury poses in various sporting contexts. Depicting the extent of an injury problem using specific metrics can be complex and challenging. While movements towards comprehensive reporting are important, it is equally vital to consider the inherent characteristics of the metrics and measures reported in epidemiological studies. These considerations influence how general consumers understand the information and how medical professionals perceive and respond to the broader implications of sports-related injuries. The aim of this article is to critically examine the complexities surrounding summary metrics used to represent injury sequelae in sports injury epidemiology and to advocate for nuanced approaches to conceptualising and reporting the impact of sport-related injuries. Various methods have been used to describe the epidemiological features of injuries and to evaluate the efficacy of injury prevention measures.4–6 In efforts to describe injury sequelae, measures such as severity and injury burden are frequently employed alongside the calculation of injury incidence rates.3 While the authors herein endorse using various metrics to comprehensively illustrate the scope of injury issues, we advocate for thoroughly considering the inferential implications of the reported measures to provide a clear and multifaceted understanding, particularly for clinicians. Historically, reporting injury severity—often equated with time loss—has been a mainstay in sports injury research.7–9 Similarly, there has been a recent surge in the reporting of injury burden, typically quantified as the product of the injury incidence rate and average time loss.10 Disregarding the mathematical intricacies of calculating these measures, it is pertinent to acknowledge that metrics such as ‘severity’ and ‘burden’ represent latent or unobserved constructs. Therefore, while it may be convenient to enumerate …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"79 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Delphi consensus on bone stress injuries in athletes","authors":"Tim Hoenig, Karsten Hollander, Kristin L Popp, Michael Fredericson, Emily A Kraus, Stuart J Warden, Adam S Tenforde","doi":"10.1136/bjsports-2024-108616","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108616","url":null,"abstract":"Bone stress injuries, commonly referred to as stress reactions and stress fractures, represent overuse injuries to bone. These injuries result in physical limitations in activity and can be career-ending for high-level athletes. While bone stress injuries have received increased attention in recent years, international consensus is lacking on definitions, risk factors and strategies for management and prevention. This study aimed to ascertain and improve the level of agreement on bone stress injuries by utilising a three-part modified Delphi approach on (1) pathophysiology, diagnosis, terminology and classification systems; (2) risk factors, screening and prevention; and (3) management and return to sport. A multidisciplinary steering committee initiated the consensus process. A panel of 41 members from six continents was formed to complete three rounds of voting, including experts (scientists and clinicians) and representatives (athletes and coaches). Thirty-three, 28 and 28 panel members completed Delphi rounds 1, 2 and 3, respectively. Consensus was reached on 41 out of 58 statements. Findings from this Delphi study outline a multifactorial approach to identify and manage bone stress injuries and to promote bone health in athletes. This includes recommendations for diagnostic workup and treatment to assist clinicians in caring for patients with bone stress injuries. Finally, this consensus process identifies knowledge gaps and provides a framework for future research to advance the clinical care and prevention of bone stress injuries.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"6 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Descending stair walking as exercise medicine","authors":"Lucas Henrique L Araújo, Trevor C Chen, Kazunori Nosaka, Leonardo C R Lima","doi":"10.1136/bjsports-2024-108626","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108626","url":null,"abstract":"Over the past several decades, muscle damage represented by delayed-onset muscle soreness and prolonged decreases in muscle function has been a central agenda for exercises mainly consisting of eccentric (lengthening muscle) contractions (ie, eccentric exercises).1 However, in more recent decades, the paradigm of eccentric exercise has taken on new dimensions with accumulating evidence suggesting its positive effects on health and fitness parameters, especially by low-intensity, moderate-load eccentric exercises.1 Moderate-load eccentric exercises do not induce as much muscle damage as high-intensity eccentric exercises do, but appear to produce morphological, functional and metabolic adaptations that are important for health and quality of life.1–3 This editorial will discuss descending stair walking as an inexpensive and easily accessible moderate-load eccentric exercise modality, along with its effects on health, functional capacity and body composition. The most abundantly investigated modality of moderate-load eccentric exercise is eccentric cycling,2 3 in which knee extensor and hip extensor muscles resist against the force generated by backward-moving pedals driven by a motor in a specially designed ergometer or bicycle. Several studies have demonstrated the effectiveness of eccentric cycling in improving body composition and functional capacity.2 3 In a recent meta-analysis, Barreto et al 2 documented that eccentric cycling increases muscle strength and mass, functional capacity and aerobic power, while decreasing body fat. Similarly, eccentric stepping, in which linear instead of circular movements generated by an ergometer are performed, has been shown to improve functional capacity and body composition.4 However, the cost of the ergometers is a negative aspect of these exercise modalities.3 A modality that is inexpensive, accessible and widely implementable in daily …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"111 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Day in Sports Medicine: supporting career paths for under-represented populations","authors":"Andrew S Nowak, Gabrielle E Kennelley, Katlyn A Droke, Noshir Y Amaria, Adam Lewno","doi":"10.1136/bjsports-2024-109087","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109087","url":null,"abstract":"Identity concordance is a well-studied phenomenon that may improve physician–patient relationships, communication, and ultimately, patient outcomes.1 2 However, there are numerous barriers to identity concordance in medicine. For instance, nearly 15% of the US population identifies as ‘Black,’ and another 3% identify as ‘American Indian/Alaskan Native.’3 4 Across all identities, 27% of individuals in the USA identify as having a physical, sensory, learning or psychological disability.5 However, when looking at the identities of US physicians, only 5.7% identify as Black, 0.3% as American Indian/Alaskan Native and 3.1% as having a disability.6 7 While the analogies of ‘leaky pipeline’ and ‘pathways and potholes’ were originally coined to describe the representation of women in the science, technology, engineering and mathematics fields, they are now used more broadly to emphasise the under-represented identities in these fields, particularly in medicine.8 Many medical schools and healthcare institutions are working to patch these ‘leaks’ and ‘potholes’ and improve representation and concordance in medicine, yet the numbers suggest that there is still a …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"7 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}